Kevan Christie: SNP target-driven medicine is failing to cure seriously ill NHS

The Scottish Government should pay heed to remarks from BMA Scotland chair Dr Peter Bennie, says Kevan Christie.
The Scottish Government should pay heed to remarks from BMA Scotland chair Dr Peter Bennie, says Kevan Christie.
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The comments by Dr Peter Bennie, chair of BMA Scotland, saying that the target-driven blame culture that exists in the NHS is not “sustainable” reflects a senior medical professional who is fast approaching the end of his tether with the Scottish Government.

The open and frank appraisal of the many targets hard-pressed healthcare staff are under pressure to meet is to be welcomed.

This comes on the back of Dr Bennie saying earlier this month that health inequalities that persist between the richest and poorest parts of Scotland should “shame us as a society”.

You would think Health Secretary Shona Robison and her team of advisers would sit up and take note of Dr Bennie’s comments, with former Chief Medical Officer Sir Harry Burns saying much the same thing after completing his targets and indicators review last month.

However, Dr Bennie’s comments were met with the standard anodyne response the Health Secretary reserves for particularly bad news, wrapped up in the usual bland promises to “start the process” and devise new methods.

The Scottish Government basically ignored Professor Burns’ recommendations after commissioning him to carry out a year-long revue examining targets and indicators in health and social care – after a series of failings.

He concluded that the current system of targets and indicators is fragmented and called for a different approach which measured the “whole journey of care”.

Professor Burns also highlighted the need to improve early life and the social circumstances of people living with deprivation.

I’ve written before how the review was a “get out of jail free card” for the Scottish Government but they stubbornly insist that targets are to remain while making vague noises about them “being informed by the principles” of the report.

What’s striking about Dr Bennie’s comments is the fact that he’s not couched them in the usual carefully-crafted language you come to expect from people in senior posts.

He says “the current culture of using crude measures, often taken in isolation, to judge the complexities of the whole healthcare system, and to apportion blame, must end”.

He stops short of drawing Shona Robison a picture – but the message could not be any clearer.

The Scottish Government’s obsession with targets is not doing NHS Scotland any favours.

We now have two senior health professionals heavily criticising the target culture against a backdrop of a weekly updates on the “worst ever” A&E waiting times being reported by the media and seized on by hungry opposition parties who smell blood.

It’s clear the Scottish Government don’t have a proper feel for what is going on in the health service and are not listening. In recent months the default setting is to claim NHS Scotland is receiving record funding, has the highest number of staff ever and, crucially for the SNP, is performing better than NHS England.

The performing-better-than-England trope has been wheeled out again and again but is hard to gauge on a like-for-like basis, if you feel the need to do this, given the size and scale of the NHS down south.

Of course, this claim was before beleaguered NHS Lothian staff took it upon themselves to set up their own recording system for A&E waiting times as, wait for it – the Scottish Government one was too “vague and ambiguous”.